URC/CHS News Archives | Contact us | Home

URC/CHS News

Women Making a Difference

Refiloe Matji, South Africa
URC Regional Director for Southern Africa and Director, TASC2 Tuberculosis IQC

By Donna Jacobs

Dr. Refiloe Matji is a physician and public health specialist who is passionate about fighting the global threat posed by tuberculosis (TB). As Director of URC's TASC2 Tuberculosis Indefinite Quantity Contract and Regional Director for Southern Africa, Refiloe oversees the TASC2 TB Project in South Africa, funded by USAID and PEPFAR, and USAID Health Care Improvement Project activities in South Africa, Lesotho and Swaziland which are aimed at improving the quality of TB, HIV/AIDS, and TB-HIV integrated services. She advises URC’s Improving Medical Injection Safety Project in Namibia, also funded by USAID.

Dr. Matji (left) speaks to school children in Durban, South Africa on World TB Day in 2006.

Refiloe’s story is even more remarkable by the trajectory that led her to become a leader in the fight against TB and TB-HIV in Southern Africa.  Born in South Africa, she grew up in nearby Lesotho, where her father, a member of the African National Congress, was exiled during the apartheid era. She attended medical school in Russia. Despite opportunities to work anywhere in the world, after completing her medical studies, she returned to work in Lesotho, a country with a severe shortage of doctors.

It was while working as superintendent of a district hospital in Lesotho in 1990 that Refiloe developed an initial interest in treating TB. There she saw firsthand the magnitude and multi-factorial nature of the disease, as the majority of TB patients were ex-miners facing numerous socio-economic problems that contributed significantly to high rates of treatment default. She also realized that a lack of follow-up systems for TB patients negatively impacted treatment outcomes and contributed to development of anti-microbial resistance. Refiloe found that spending additional time and effort motivating patients to comply with their treatment and enlisting the support a local priest to provide spiritual guidance to perpetual TB defaulters led to higher treatment success. She was given an opportunity to visit the World Health Organization (WHO) in Geneva where she learned about the directly observed treatment (DOTS) strategy and developed a keen interest in improving TB services. She then became the National TB Control Program Manager for the Ministry of Health of Lesotho, where she was responsible for introducing the DOTS strategy.

Buoyed by her experiences in Lesotho, Refiloe undertook post-graduate training in respiratory medicine and TB and completed a Master of Public Health degree at the University of Wales in 1996. At that time, WHO had completed a review of the TB program in South Africa and had recommended that staff and stronger programmatic guidelines were needed to revitalize TB control. Refiloe was nominated to become the new National TB Manager for South Africa’s National Department of Health (DOH).

Refiloe describes this next chapter as the most amazing years in her working life. She re-built the national TB program from the ground up, launching the DOTS strategy in South Africa and expanding it to the entire country within a time span of only four years. She fostered a national recognition of the TB epidemic and the political commitment essential for effective program implementation and sustainability. Working with WHO and UNAIDS, she developed pilot TB-HIV programs at the district level to transform HIV testing to an entry point to a range of HIV and tuberculosis prevention and care services. The success of interventions at the pilot sites helped the Department of Health mobilize funding from the Global Fund for scale-up of TB-HIV program integration. Recognizing the emerging threat of multi-drug-resistant (MDR) TB, Refiloe worked with the Medical Research Council of South Africa to establish the first nation-wide MDR TB surveillance system in South Africa. 

She offers praise for the international consultants with whom she worked in those years, including Dr. Karel Styblo, the “Father of DOTS” at the Royal Netherlands TB Association (KNCV) and Professor Don Enarson of the International Union Against Tuberculosis and Lung Disease (IUATLD). From them, she learned to fight for the rights of TB patients, who often lacked a voice; as well as the need for perseverance and dedication to TB work; for focusing on the positive aspects of health workers’ efforts, and for giving support to frontline providers, who often feel overwhelmed by the challenges they face.

With the birth of her daughter Yolanda in 2001, Refiloe reduced her travel and subsequently left the DOH in 2002, reducing her work to consultancies. But the problem of TB in South Africa still beckoned. In 2004, she joined URC and went back to work on TB programs full time, now serving as an advisor who knew where the gaps were, the constraints on the DOH, and how to leverage USAID resources to help the national TB program move ahead to face the emerging challenges of multi-drug-resistant TB. Eventually, Refiloe took on new projects in Lesotho and Swaziland to address the growing threat of TB-HIV co-infection in those countries. 

Today, Refiloe’s leadership and expertise in the fight against TB and TB-HIV are recognized internationally. She is a founding member of the Southern African Tuberculosis Control Initiative (SATCI) and serves on several international working groups, including the WHO TB Advisory Committee, the WHO working group on multi-drug resistant tuberculosis (MDR TB) of the DOTS-Plus Initiative, and the Advisory Committee of IUATLD. She also, after 19 years, had an opportunity to return to Russia to share lessons learned from her work in Southern Africa as the keynote speaker at a national forum on TB-HIV co-infection in Moscow. 

Refiloe finds her motivation in visiting clinics and seeing patients who have survived and have a better life because of the work she supports. She believes that we cannot measure success in terms of percentages but rather in terms of lives saved. Through her work, Dr. Refiloe Matji has increased TB-HIV awareness as a critical issue and has made it a priority among health departments throughout Southern Africa, where she is truly making a difference in the lives of TB and TB-HIV co-infected patients.

Back to top